- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.45 / $9,062.00 / $18,276.00
| Facility | | $505.45 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,013.97 / $9,123.49 / $15,461.42
| Facility | | $4,013.97 | $9,123.49 | $15,461.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.24 / $815.00 / $2,581.96
| Facility | | $509.24 | $815.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $528.00 / $941.01
| Facility | | $443.00 | $528.00 | $941.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,401.48 / $15,451.00 / $23,485.00
| Facility | | $2,401.48 | $15,451.00 | $23,485.00 |